Because of the previous reported activity of the combination of streptozotocin 500 mg/m2 IV days 1-5, CCNU 100 mg/m2 orally day 1, Adriamycin 45 mg/m2 IV day 1 and bleomycin 15 mg/m2 IM days 1 and 8 (SCAB) given at 28 day intervals in patients with previously treated Hodgkin's disease, this regimen has been employed for 20 patients with stage IIIB, IVA or IVB previously untreated Hodgkin's disease. The complete response rate in this previously untreated group was 75 percent (15/20). Of the 5 patients who failed to obtain complete remission, 2 had partial remissions and 3 patients failed to respond. Remission duration will be in excess of a median of 15 months with patients still being followed from 5 plus to 41 plus months in remission. There have been 2 relapses of disease at 5 and 12 months. Toxicities seen with this regimen were similar to those seen in the previously treated group. Moderate myelosuppresion was seen with platelets being affected more than white cells. Liver dysfunction not attributable to Hodgkin's infiltration of the liver occurred in 6 patients; 5 patients had weight loss presumably secondary to chemotherapy; bleomycin pulmonary toxicity was seen in 5 patients; and 4 patients had mild increases in their serum creatinines. SCAB appears to be effective therapy for patients with advanced, previously untreated Hodgkin's disease.